- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $6,606.93 / $13,182.57
| Facility | | $467.74 | $6,606.93 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $851.14 / $851.14
| Facility | | $851.14 | $851.14 | $851.14 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.03 / $691.83 / $812.83
| Professional | | $537.03 | $691.83 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $549.54 / $6,606.93
| Facility | | $338.84 | $549.54 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $616.60 / $676.08
| Facility | | $489.78 | $616.60 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.13 / $524.81 / $741.31
| Facility | | $331.13 | $524.81 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $5,011.87 / $6,165.95
| Facility | | $3,801.89 | $5,011.87 | $6,165.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $8,128.31 / $12,882.50
| Facility | | $1,995.26 | $8,128.31 | $12,882.50 |